It's well-known in the trade that there is an upcoming public health crisis because of antibiotic resistance, yet the biggest research efforts go to cancer drug

It's well-known in the trade that there is an upcoming public health crisis because of antibiotic resistance, yet the biggest research efforts go to cancer drugs because that's what provides the highest return on investment. Hell, I am on cancer money, but what we really need is new antibiotics! Also, no one wants to introduce any new class of drug to the market because the research effort is too expensive and the market does not exist. The market in current statins is so much bigger than it was when Merck introduced the first one, and they had to go and verify the target, the mechanism, everything. Merck did all that for every other competitor that wants to bring another statin to market. It really is the financing model that is opposed to the public good. People will admit it freely. And the heat that the FDA gets when something slips past them is incomparably smaller than the heat the pharmco gets. Anyone remember Vioxx and the cardiac side effects? The FDA's incentives are aligned with the public good. There are already drugs for most conditions, and if there is anything that performs outstandingly well in clinical trials there is the fast track. As for the natural monopoly, it's a fact that the number of manufacturers for any given drug is surprisingly small. For orphan drug the market is so small that it's inevitably just one manufacturer. The upfront costs to qualify equivalence are just a contributor.